Department of Immunology, Hospital Universitario Central de Asturias, Oviedo 33006, Spain.
BMC Med. 2014 Feb 25;12:34. doi: 10.1186/1741-7015-12-34.
Overexpression of autologous proteins can lead to the formation of autoantibodies and autoimmune diseases. MHC class I polypeptide-related sequence A (MICA) is highly expressed in the enterocytes of patients with celiac disease, which arises in response to gluten. The aim of this study was to investigate anti-MICA antibody formation in patients with celiac disease and its association with other autoimmune processes.
We tested serum samples from 383 patients with celiac disease, obtained before they took up a gluten-free diet, 428 patients with diverse autoimmune diseases, and 200 controls for anti-MICA antibodies. All samples were also tested for anti-endomysium and anti-transglutaminase antibodies.
Antibodies against MICA were detected in samples from 41.7% of patients with celiac disease but in only 3.5% of those from controls (P <0.0001) and 8.2% from patients with autoimmune disease (P <0.0001). These antibodies disappeared after the instauration of a gluten-free diet. Anti-MICA antibodies were significantly prevalent in younger patients (P <0.01). Fifty-eight patients with celiac disease (15.1%) presented a concomitant autoimmune disease. Anti-MICA-positive patients had a higher risk of autoimmune disease than MICA antibody-negative patients (P <0.0001; odds ratio = 6.11). The risk was even higher when we also controlled for age (odds ratio = 11.69). Finally, we found that the associated risk of developing additional autoimmune diseases was 16 and 10 times as high in pediatric patients and adults with anti-MICA, respectively, as in those without.
The development of anti-MICA antibodies could be related to a gluten-containing diet, and seems to be involved in the development of autoimmune diseases in patients with celiac disease, especially younger ones.
自身蛋白的过表达可导致自身抗体的形成和自身免疫性疾病。MHC Ⅰ类多肽相关序列 A（MICA）在乳糜泻患者的肠上皮细胞中高度表达，乳糜泻是对麸质的反应。本研究旨在探讨乳糜泻患者抗 MICA 抗体的形成及其与其他自身免疫过程的关系。
我们检测了 383 例未经无麸质饮食治疗的乳糜泻患者、428 例多种自身免疫性疾病患者和 200 例对照者的血清样本，以检测抗 MICA 抗体。所有样本还检测了抗肌内膜和抗转谷氨酰胺酶抗体。
乳糜泻患者样本中检测到抗 MICA 抗体的比例为 41.7%，而对照组为 3.5%（P<0.0001），自身免疫性疾病患者为 8.2%（P<0.0001）。这些抗体在实施无麸质饮食后消失。抗 MICA 抗体在年轻患者中更为常见（P<0.01）。58 例乳糜泻患者（15.1%）同时患有自身免疫性疾病。与 MICA 抗体阴性患者相比，抗 MICA 阳性患者发生自身免疫性疾病的风险更高（P<0.0001；比值比=6.11）。当我们也控制年龄因素时，风险甚至更高（比值比=11.69）。最后，我们发现，在儿童和成人中，MICA 阳性患者分别发生其他自身免疫性疾病的风险比 MICA 阴性患者高 16 倍和 10 倍。
抗 MICA 抗体的产生可能与含麸质饮食有关，并且似乎与乳糜泻患者自身免疫性疾病的发生有关，尤其是年轻患者。
